NextGate Responds to CMS FY20 IPPS Proposed Rule

Leading patient identification solutions provider centers comments on agency’s request for information on patient matching

PASADENA, Calif., June 20, 2019 NextGate, the global leader in enterprise patient identification, today submitted comments to the Centers for Medicare and Medicaid Services (CMS) in response to a request for information on the Provider to Patient Exchange Objective and direct questions regarding patient matching as part of the proposed Inpatient Prospective Payment System (IPPS) rule for FY20.

In a letter to CMS Administrator Seema Verma, NextGate praised the agency for supporting the development of patient matching initiatives and engaging with the private sector to further patient identification technology as a means to advance interoperability.

Echoing the agency’s assessment that a unique patient identifier is not the silver bullet solution to achieve the patient matching levels required by today’s increasingly complex health IT environment, NextGate pointed to a mix of sustainable and proven technologies, process automation and rigorous attention to data quality as the best route forward.

“Fundamentally, we believe that use of an enterprise master patient index (EMPI), augmented with other technology and process approaches, is the most promising path to near-term, substantial increases in patient matching effectiveness,” the letter stated. Further, NextGate added that it favors a bottoms-up approach versus a centralized patient identity matching strategy to “integrate disparate systems and emphasize the need for continual increases in the quality of the underlying data used for matches.”

For over two decades, NextGate has been helping healthcare organizations around the world overcome the clinical, operational and financial challenges that result from duplicate records and disparate systems. Its flagship EMPI solution currently manages patient identities for more than two-thirds of the U.S. population and one-third of the populations in the U.K. and Australia.

A firm believer that accurate patient identification is a prerequisite for interoperability, NextGate addressed several key areas for advancing nationwide matching efforts, including:

  • Deterrence of a mandated patient matching algorithm or single software vendor solution.
  • Advancement of standardized data elements and technology for the purpose of matching and maintaining data quality, specifically those that facilitate the consistent capture of demographic information such as addresses.
  • Cautionary use of identity proofing or third-party reference data, including credit or financial information, that does not support matching efforts for minors or immigrants.
  • Considerations for looking beyond EHRs as the owner of patient identity, stating that the core identity of a patient and basic associated demographics should not be in the control of any single system, but rather externalized from such insulated applications to maintain accuracy and consistency across all connected systems within the delivery network.

“NextGate’s comments focus on how best to utilize EMPI technology with other promising innovations, as well as standards for demographic data, to tackle the clinical, financial and operational inefficiencies induced by poor patient identification,” said NextGate CEO Andy Aroditis. “We appreciate CMS’ clear recognition of the value that the private sector brings to tackling this critical patient safety and interoperability issue and welcome the opportunity to serve as a resource for the agency going forward.”

The full text of NextGate’s letter to CMS can be found here.

About NextGate
With over 200 customers in four countries, NextGate is the global leader in healthcare enterprise identification. Committed to helping organizations overcome the clinical, operational and financial challenges that result from duplicate records and disparate data, our full suite of identity matching solutions connects the entire healthcare ecosystem to drive critical improvements in quality, efficiency and safety. NextGate’s market-leading EMPI currently manages 300 million lives and is deployed by the nation’s most successful healthcare systems and health information exchanges. For more information, visit www.nextgate.com.

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Media Contact:
Stephanie Fraser
Director of Communications and Media Relations, NextGate
c: 734-233-1483 | o: 734-399-9336
stephanie.fraser@nextgate.com

Read the PDF.